Children with acquired brain injuries comprise the largest diagnostic group requiring inpatient care in specialized rehabilitation hospitals. For accreditation purposes, these hospitals will be required to collect performance measure data for high-volume patient groups beginning in 1998. This mandate presents a serious dilemma, since current performance measures in pediatric rehabilitation are inadequate to guide internal improvements or to evaluate comparative performance. To address these deficiencies, the principal aims of Phase I are to: (1) develop a working model for a clinical performance measure prototype based on expert feedback (2) develop new items for the prototype, and (3) demonstrate feasibility, clinical acceptance and criterion-related validity of the performance measure by collecting data on recent discharges from representative clinical sites. In Phase II of the research project, we will conduct further field studies of the performance measure's reliability, validity, refine the scaling approach for each dimension, create benchmarking indices, develop classification systems for diagnostic types/ severity, and finalize risk- adjustment methodologies. The final product of Phase II will be nationwide performance measurement system for children with acquired brain injury that will meet content and measurement requirements of multiple accreditation and contracting agencies. PROPOSED COMMERCIAL APPLICATION: The product of this SBIR project will be a marketable Performance Measurement System for children with Pediatric Brain Injury. As of 1998, all JCAHO accredited hospitals will need to contract with a data system to provide comparative data for high-volume patient groups. This Performance Measure meets all the JCAHO requirements and will fill a critical void for inpatient pediatric rehabilitation programs. Many acute care children's hospitals may also find this measure helpful in comparing performance of trauma care for children who are directly discharged home.